Facelift and Neck Lift Surgery Principles
Written by Dr. Julian De Silva
There are various terms and descriptions that have been used to describe facelift lifting techniques and surgery. The terms listed below are the common facelift terms that have been described, other facelift terms have been trademarked and marketed, these are variations of the techniques described below.
The conventional facelift used an incision that followed the hairline; beginning at the temple and going down, behind the ears and back up to the other ear and returning into the hair. After completing the incision, the skin is lifted, pulled upwards and backwards. The underlying muscles termed SMAS (Superficial muscular aponeurotic system) is usually elevated with a mixture of techniques in front of the ear. The excess skin that overlapped was then trimmed away, and re-stitched where the cut was originally made. The skin was closed with the use of stitches or metal clips. A hospital stay for a minimum of one day was required and all patients had general anaesthesia.
Mini Facelift or Short-Scar Facelift
A Mini facelift is a cosmetic procedure performed that involves a shorter incision around the ear, it is useful in treating younger patients with facial ageing with soft tissue changes of the lower part of the face and jowl area. This surgery offers the advantage of a smaller incision and faster recovery, it does not address marked skin laxity or facial ageing of the neck tissues characterised with vertical. If further there is marked skin laxity of the face or neck, Dr. De Silva would recommend additional techniques to give an improved result.
MACS lift (Minimal Access Cranial Suspension)
A MACS lift is involves smaller incisions than the traditional surgical method. In this procedure slits are made in the temple and in the front part of the ears which is followed by permanent re-stitching. The MACS lift is suitable for relatively mild facial ageing as the surgery involves the use of 2-3 sutures to lift the face, the support to the face is substantially less than other facelift types. This facelift is has a shorter duration than the classical facelift that result in lifting of the underlying muscle/ SMAS tissue.
A midface lift is a cosmetic surgery that is used to elevated the area of the cheeks and can be formed with open incisions under the eyelid or hidden incisions in the hair or mouth. Elevation of the midface does improve the middle third of the face, however facial ageing tends to also effect the upper and lower thirds of the face.
Deep Plane Facelift
The face is organized in layers of tissue that includes the skin, underlying SMAS and skeletal structure. Dr. De Silva uses a modified deep plane lift to maximize the elevation of the face in natural planes, avoiding unnecessary injury to vessels, and speeds up recovery. Keyhole surgery in which a telescope is used to evaluate the soft tissues and muscle layer that underlies the skin, enabling smaller incisions to be used and hidden scars. The advantage of Dr. De Silva’s deep plane is an improved lift that is longer lasting lifting of the face, added safety and reduced recovery time.
Which Facelift Technique is best for me?
Dr. De Silva teaching facelift surgery in Las Vegas, USA, Surgical techniques SMAS lifting versus Deep Plane Lifting
There is no one technique that will give the best result for every patient. Each person’s face is unique, a combination of genetics, environmental influences and lifestyle choices will influence a person’s face. Mini-face lift techniques offer patients a solution that requires less surgery and downtime however is not appropriate for all facial ageing. Key to a natural looking result is elevation of the soft tissues beneath the skin, lifting the facial tissues to their natural location before the consequences of ageing with laxity and gravitational descent result in signs of facial ageing. Dr. De Silva prefers techniques that give the patient the longest lasting effects and natural looking results, the technique differs depending on a person’s face. Essential to a natural looking result is meticulous attention to facial skin to hide incisions in the natural contours of the face and avoid scarring, a good result should not result in visible scarring months after surgery.
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